Cushing syndroom

Het 'syndroom' van Cushing is de verzamelnaam van alle klachten die veroorzaakt worden door de (meestal langdurige) blootstelling aan teveel cortisol in het bloed. Een patiënt met deze klachten heeft de ziekte van Cushing.

In de hersenen zit een kliertje (de hypofyse). Dit kliertje maakt een hormoon aan (ACTH) dat de bijnier stimuleert.

Er kan te veel cortisol in uw bloed komen als de hypofyse te veel bijnierschorsstimulerend hormoon (ACTH) aanmaakt. Daardoor gaat de bijnier te hard werken en maakt te veel cortisol.

Soms kan een gezwel in de bijnierschors extra veel cortisol maken en zo het syndroom van Cushing veroorzaken.

Ook medicijnen kunnen het syndroom van Cushing veroorzaken. Het komt vooral voor bij langdurig gebruik van het medicijn prednison

Kruiden onder controle te proberen bij Cushing: vooral adaptogenen (Panax, Rhodiola..), hormonaal werkende planten (Vitex..) en mogelijk ook sedativa (Melissa...) zijn te proberen

Ginseng

Michael Murray, N.D. and Joseph Pizzorno, N.D., authors of "The Encyclopedia of Natural Medicine," propose that excessive hormone release impairs the body's ability to appropriately respond to stress. Both Panax ginseng and Siberian ginseng are regarded as adaptogens, which means that they enhance the body's ability to cope with physical and mental stress. Specifically, the authors state that ginseng counteracts the negative effects of elevated serum cortisol levels.

Kampo Medicines

Kampo medicine, also known as the Han Method, is a component of traditional Chinese medicine developed during the Han dynasty and now adopted in Japan and Taiwan. While Kampo integrates several modalities such as acupuncture, it is heavily based on combination herbal remedies. Researchers at the Oita University Hospital in Japan tested the effects of two Kampo herbal remedies on serum cortisol levels under stress-induced conditions. Specifically, the team investigated the activity of Sho-hange-ka-bukuryo-to and Nichin-to, both of which contain the herbs Pinelliae tuber and Zingiberis rhizome. The results, which were published in the Oct. 27, 2004 issue of Biological and Pharmaceutical Bulletin, showed that the Sho-hange-ka-bukuryo-to formula decreased blood cortisol levels, but the Nichin-to formula did not. Individually, the herb Pinelliae tuber had no effect on cortisol levels, while Zingiberis rhizome significantly reduced serum cortisol levels.

Vitex agnus-castus

Herbalists have known for years that Chaste Berry (Vitex agnus-castus) alters prolactin levels. The research being carried out in the UK is by the Laminitis Trust. They are continuing an earlier study by a group in the USA. Chaste Berry is a herb used in the treatment of hormonal imbalance in women. It is particularly useful in the treatment of mood swings and other adverse symptoms surrounding the monthly cycle.

The preliminary findings of the American group show excellent results. Here is an edited report.

“We initially gave Vitex to a horse and two ponies (all geldings) with classical Cushing's symptoms. The manufacturer of Hormonize, recommended we use the larger end of the recommended dosage scale and give it daily, rather than in three-weeks-on/one-week-off cycles.

The response was rapid and dramatic. Within two to three weeks, shedding was occurring rapidly. One pony was white and would leave huge piles of hair (giant nests) around the field. The old hair had been coarse, dry, thick and curly, but the new growth was normal, sleek and had a high shine.

All three geldings shed out completely for the first time in years, most with an early large loss of hair, followed by continued slower shedding or a few bursts of shedding until the abnormal hair was lost.

The other obvious change was increased energy levels. A chronically foundered pony was also getting around much better, even trotting, although no one would call him sound. It was difficult to tell if the increased activity level was related to his newfound energy or to improvement in the laminitis.

One pony failed to receive his Vitex for a three-week period, due to communication problems with the caretakers. Interestingly, his energy level dropped again and the abnormal coat began growing back rapidly. Resuming the Vitex led to a rapid shed and higher energy.” (Thanks to the Horse Journal)

Taraxacum / Dandelion

in some more mild situations, using natural remedies such as dandelion can be enough to quell the symptoms of the disease. According to a 2004 University of British Columbia study, the compounds within dandelion-luteolin and luteolin-7-O-glucosid-were found to have significant antioxidant that serves as a great tonic for kidneys, liver, and adrenal glands. Thus, dandelion can serve as a great remedy to normalize cortisol production and adrenal functions.

Because the sterol component of the herb is similar to those created by adrenal glands, dandelion has used to support the gland and can be utilized as such to relieve the disease.

One particular natural supplement, Supraglan, which contains dandelion, wild yam, milk vetch, and other herbs, can lower the amount of cortisol produced by the adrenal gland.

Arctium lappa / Burdock to Detoxify Your Body to Relieve Cushing's

The herb, arctium lappa or more commonly known as burdock, can be used to help maintain adrenal function if you suffer from Cushing's disease. Its primary function as a natural remedy is to cleanse and eliminate unwanted substances through urine and sweat. Because the disease causes abnormal cortisol levels, burdock works as a great natural rememdy since it helps return the adrenal gland back to equilibrating normal cortisteroid levels.

According to a Kingley Veterinary Center in West Wessex, UK study that examined 41 canines discovered that approximately 80 percent shows improvements after homeopathic and herbal remedies.

Herbal Therapy & the Adrenal Glands

Alternative medicine abounds in ideas about and remedies for the adrenal glands. Unfortunately they are often just an expression of a fundamental lack of knowledge about the adrenals. The ideas couched in these terms are often valid and helpful, but invoking some adrenal tonic effect must be based upon actual physiology and not pseudo-science.

The two adrenals sit astride each kidney, deep in the back part of the abdomen. However, it is vital to recognize that each of these glands has two parts, a cortex or outer part, and a medulla or central portion. These have markedly different functions. When therapy is directed towards these glands, it must be appropriate to the adrenal function the practitioner wants to address.

Adrenal Medulla

The adrenal medulla secretes the hormones adrenaline (epinephrine) and noradrenaline (norepinephrine), responsible for the rapid increases in nervous system and metabolic activity involved in the stress response. Summarizing the effects of these two hormones

Adrenaline (epinephrine)

Acts on [alpha] and [beta] receptors.
Increases contractility & excitability of heart muscle, thus increasing cardiac output.
Facilitates blood flow to muscles, brain, and viscera
Enhances blood sugar levels by stimulating conversion of glycogen to glucose in liver.
Inhibits smooth muscle contraction.

Noradrenalin (norepinephrine)

Acts primarily on [alpha] receptors.
Increases peripheral vascular resistance, leading to increased blood pressure.
Adaptogens are the core of this support, with saponins such as the eleuthero sides directly impacting the medulla. Nervine tonic support of some kind is usually indicated as well, although this does not directly impact the medulla. The contribution from such nervines is a more generalized systemic support that eases the impact of tension and anxiety. Bitter tonics can be helpful as well.

Examples might include

Adaptogens: Panax spp.(Ginseng ), Eleutherococcus senticosus (Siberian Ginseng)
Nervine Tonics: Scutellaria later if olia (Scullcap), Hypericum perforatum (St. John's Wort), Avena sativa (Oats)

Adrenal Cortex

The cortex is responsible for production of glucocorticoids, such as cortisol, which have a regulatory effects on metabolism, the immune system, certain aspects of behavior, and many other processes. The cortex also secretes aldosterone, fundamental to the homeostatic control of sodium and potassium secretion by the kidney. These hormones are synthesized from cholesterol.

Glucocorticoids (cortisone and hydrocortisone)

Enhance protein catabolism and inhibit protein synthesis.
Antagonize action of insulin.
Increase synthesis of glucose by liver
Influence defense mechanism of body and its reaction to stress.
Influence emotions.

Mineralocorticoids (aldosterone, desoxycorticosterone)

Regulate re-absorption of sodium cation.
Regulate excretion of potassium cation by renal tubules.

Adrenosterones (adrenal androgens)

Whilst the cortex and medulla produce different hormones in response to differing stimuli, they share a complex role in some situations, for example the stress response. As has been described in the section on stress, the immediate response is controlled mainly, though not completely, by the adrenal gland's central medulla, while long-term response is handled by the surrounding cortex. The initial response-preparing the body for what has been called the fight-or-flight reaction-involves:

Increased nervous-system activity.
Release of adrenaline and/or noradrenalin into the blood stream by the adrenal medulla. These hormones support the nervous system through metabolic activity.

The body's response to these chemicals includes:

increase in heart rate and blood pressure
surface constriction of blood vessels, so that the blood leaves the skin to provide the muscles with more sugar and oxygen (which is why we go white with shock).
mobilization of the liver's energy reserves through the release of stored glucose.

If the stressful situation is very intense or continues over a period of time, the adrenal cortex becomes increasingly involved in the stress reaction. The activity of the cortex is largely controlled by blood levels of adrenocorticotrophichormone (ACTH), which is released by the anterior pituitary gland. When information about sustained stress has been processed by the central nervous system, a whole range of new bodily responses occurs, and it is these longer-term reactions that can adversely affect the quality of life.

Herbs for the Adrenal Medulla

Adaptogens are the core of adrenal medulla support, with saponins such as the eleuthero sides directly impacting the medulla. Nervine tonic support of some kind is usually indicated as well, although this does not directly impact the medulla. The contribution from such nervines is a more generalized systemic support that eases the impact of tension and anxiety. Bitter to nicscan be helpful as well. Examples might include

Adaptogens: Panax spp.(Ginseng ), Eleutherococcus senticosus (Siberian Ginseng)
Nervine Tonics: Scutellaria laterifolia (Scullcap), Hypericum perforatum (St. John's Wort), Avena sativa (Oats)

Herbs for the Adrenal Cortex

Herbal medicines can impact the adrenal cortex in a variety of ways. Most important is the direct effect of plants rich in a specific variety of saponin such as Glycyrrhiza glabra (Liquorice). Glycyrrhiza is proving to be a controversial remedy because of its effects upon the adrenal cortex. Aldosterone is part of what has been called the renin-aldosterone-angiotensin axis, a hormonal homeostatic complex that regulates electrolyte balance in the blood and volume of urine passed. When Glycyrrhiza is eaten or taken in great excess it has a direct impact upon aldosterone leading to potassium depletion. This is a very rare occurrence, but the pharmacology books make a big point of it, to demonstrate the dangers of herbal medicine. On the other hand there are well known cases in Britain of people with addisons disease benefiting greatly from this herb. Thus in overactive conditions Glycyrrhiza should be avoided but in under active it is indicated.

As discussed briefly above, the adaptogens will support the cortex in its response to ACTH.

Cushing's Syndrome

This entity is caused by excessive cortisol, and derives from either excess ACTH from the pituitary, excess production from the adrenal itself, or the use of the cortisone-like steroid drugs. This last cause is all too common.

Adrenal Insufficiency

When both adrenal glands are largely destroyed by lack of circulation during shock or hemorrhage, by infection with tuberculosis or other diseases, by hemorrhage directly into the glands, or by a poorly understood autoimmune disorder, adrenal insufficiency is said to occur. Other causes are less common.

The lack of cortisol leads to increased stimulation by the pituitary in the form of ACTH production. This hormone in excess causes darkening of the skin, one of the early symptoms of adrenal insufficiency. Other symptoms include weight loss, weakness, loss of appetite and energy, and low blood pressure. With any physiologic stress, total decompensation can occur with shock, major chemical imbalances in body chemicals, and death. This emphasizes the importance of cortisone in the body's reaction to stress.

The commonest cause of adrenal insufficiency is the medical use of prednisone or other cortisone-like drugs. When administered for more than two weeks, the drug suppresses the body's own cortisone production which then goes into abeyance for a long time. When the drug is discontinued after prolonged use, months may be required for the body to restore its own production. During this interval adrenal insufficiency may be present, and under stress a true emergency may arise. It is for this reason that such doses are tapered off slowly.